Capsaicin (an active component of chili peppers) as a treatment for migraine, severe headaches or pain flits in and out of the news. For migraine, the preferred form is a nasal spray. Ausanil, a nasal spray of capsaicin and ginger, is the latest entry into the marketplace.

The company sent me a free sample bottle and, after I tested it once, I interviewed company founder Dr. Anjan Chatterjee. Dr. Chatterjee is a neurologist by training who has worked in drug development for the last 10 years. He also has migraine and is unable to take many medications, but has found relief with Ausanil, which he’s been using for three years.

How Ausanil is Said to Work

Capsaicin nasal spray is thought to work for headache and migraine by desensitizing the trigeminal nerve (which it accesses through the nose) and reduces CGRP, thus reducing swelling and inflammation. CGRP, as we’re learning, is thought to play a pivotal role in migraine.

The Research

Capsaicin is known to be effective for pain relief, but there’s not resounding evidence – or even very many studies – that show its efficacy for any headache disorder. Civamide, a lab-created version of capsaicin, was promising in a few small studies, but drug development was halted early. I don’t know if that’s because it wasn’t very effective, didn’t have a high enough profit potential, patients hated the sting or if it was due to some other reason.

A study presented at the American Academy of Neurology last week tested intranasal capsaicin (presumably Ausanil, since Dr. Chatterjee was one of the researchers and his company is mentioned in the PR materials) in 18 patients with a variety of headache disorders that cause severe pain (including migraine, cluster headache and tension-type headache). Thirteen participants reported complete pain relief, four had some relief and one had no relief. Relief lasted between 30 minutes and several hours. (According to those criteria, the 30 minutes of pain relief the first time I tried Ausanil would be considered a positive response, even though the pain came back even worse than before I used it.)

My Experience

I wanted to test Ausanil as any consumer would, so I tried it before I talked to Dr. Chatterjee. I read the package instructions, looked at the website and watched the YouTube video on using Ausanil correctly. That’s more thorough than I usually am. I was about to spray chili pepper up my nose and didn’t want it to hurt more than necessary.

Use 1: I sprayed Ausanil in both nostrils. It burned. A lot. The stinging hurt intensely for about 15 minutes and was gone after 30. The initial pain relief was also gone after 30 minutes… and the migraine came back worse than before I used the spray.

Use 2: After talking with Dr. Chatterjee, I gave the spray another try. This time, I only sprayed it in the left nostril since the migraine was concentrated above my left eye. The stinging wasn’t as intense, likely because it was only one nostril, but it still hurt. The spray didn’t provide any pain relief this time, not even through the distraction of the stinging. It didn’t make the migraine worse, though it seemed to render ineffective the triptan I took 15 minutes beforehand.

Two tests were enough (in fact, Dr. Chatterjee usually says that if it doesn’t work, a person shouldn’t bother trying it again). Considering the potential pain of a migraine, the stinging isn’t a big deal. I would gladly trade 30 minutes of burning in my nose to stop a migraine attack. Except that it didn’t work for me.

In our call, Dr. Chatterjee said that only a few people, all of whom have chronic migraine, have told the company that the spray made the migraine worse. Most users either have a response or they don’t.

What You Need to Know

Ausanil will sting and burn when you spray it in your nose. There’s no way around that side effect. Participants in Dr. Chatterjee’s recent study said the burn lasted 2-10 minutes. He told me that the sting lessens over time and that he barely feels it anymore.

Spray it only in the nostril on the side that the migraine is on. If you have pain on both sides, you can spray it in both nostrils, but it will burn more.

Have Kleenex nearby. You may sneeze, your nose may run or your eyes might water. Use a separate tissue for your eyes and your nose so you don’t get any residual capsaicin in your eyes.

Check Ausanil’s website to learn more about the product and how it works. You can also watch testimonials from patients for whom it has been effective.

Bottom Line

I recommend giving Ausanil a try if your headaches or migraines are severe. Yes, it burns, but the burn lasts way less time than the headache or migraine would. Other than that, there are no documented side effects. The research doesn’t strongly support the use of intranasal capsaicin for headache disorders, but there’s enough there that it’s worth a try, especially if you’re not getting relief elsewhere.

To Buy

Ausanil is currently $28.95 (with free shipping) for an 8 ml bottle on Amazon. It’s strength is listed as 3x capsaicin and 3x ginger.

(I feel like a jerk telling you about a competing product after Dr. Chatterjee and his PR team were so kind and helpful. But, as a patient who has spent a lot of money on products that don’t work for me, I feel obligated to tell you about the less expensive option. The two products aren’t identical; you may find one works better than the other.)

Welcome to Kerrie Smyres' writings about chronic migraine, headache disorders, chronic illness & depression. Here you'll find coping strategies, resources, news & more to help you live a fabulous life with chronic illness.